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HomeMy WebLinkAboutapplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: o r Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT TYPE: Permit Number: Building Permit Application Commercial _X_Residential Address. � V,/i A l sA ibL CRI• Property Tax ID #: r �I 0o6©'. -QC) —q - Lot No. Site Plan Name: 6Q—. q kA-D.aQ©0P- �E1�1( i� 25 Black No. 2 Project Name; Additional work to be performed under this permit -check all that apply: Mechanical _ Gas Tank Gas Piping _Shutters Windows/Doors Electric T Plumbing Sprinklers — Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ /i0 7(). rc� Utilities: _Sewer Septic Building Height: Name_ ��M+E p 55� , Name: Z" I 4 Address: --53,5- 7-01P),... Company:, 8Cv'�t2�'�f City: \/E R6 3 a c4� State:lVL• Address: Zip Code:,3Z5 Coo Fax: `172' 50- Y30O city: Gi" �Iocj State:�L Phone No. 7 - S 6 9_ R `� 5 3 Zip Code: 3 `�4 %+� Fax• E -Mail u E -(-p40 l�R.i •�Ol'�I Phone No Fill In fee simple Title Holder on next page (if different E -Mail 1 C`C from the Owner listed above) State or County License _L _ if value of construction Is $2500 or more, a RECORDED Notice of Commencement Is required. if value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required. SUPPLE11�iENT�itCQiTRIT��N LIEN SAW il�Ki1VIATlOi! = - _,. �- DESIGNER/ENGiN" : - N � �ble TGAGE COMPANY: Not Applicable MORTGAGE O e Name. "t" i`1 : - dress: Address: �> %�k �`/ I LQt City:i State: L City: State: Zi p:LPhone 7 7 Z_ 3 (�,C� `Ir Zip: Phone: FEE SIMPLE TITLE HOLDER: T Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip; Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and Installation as indicated. I certify that no work or installation has commenced prior to the issuance of a permit. St. Lucie CountY.makes no representation that is granting a permit will authorize the permit holder to build the subject structure Home Owners Assactation rules, bylaws or and covenants that may restrict or prohibit such which is in conflict with any applicable structure, Please consult with your Home Owners Association and review your deed for any restrictions which may apply. in consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work In accordance with the approved plans, the Florida Building Codes and St, Lucie County Amendments. The following building permit applications are exempt from undergoing a full concurrency review: room additions, rooms and accessory uses to another non-residential use accessory structures, swimming pools, fences, walls, signs, screen "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWiCE FOR IMPROYEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR A 'ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Signature of Owner/ Less a/Contractor as Agent for Owner Signature of Contractor/L ense Ho STATE OF FLORIDA -•---STATE OF FLORIDA , • 4 I OF U X-C 0 1 COUNTY OF — "'JiI ren Iy COUNTY The f going instrument was acknowledged before me The fo,�oinginstrume t �Wa$ acknowlecig before me this' day of m 20 by this day of 2Q by o�S �gvl%6KC N Name o person making statement. Name of person making statement. Personally Known V OR Produced Identification Personally Known OR Produced identification Type of Identification Type of Ideawcatiorl1 t � Produced Produced / Y`�71W (Signature of o ary Pub - 9$h9ftd (Signature of Notary Public- to a rryi a) MARGARITA LOW "a F'U'.. JULIE BARRETT NOTARY PUBLIC ff Nota t Pu lic - State of Florida j — Commission i ' �C Commission No. q ; o �4TE OF FLORID c8 on cc za3z4z My Comm. Expires Sep 28, 2022 Comm# GG111510 iy 0 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 2/7/19